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DAS28-CRP information

The DAS28-CRP [1] is a Disease Activity Score, part of the many « DAS » scores for Rheumatoid Arthritis, very useful to make an objective, reproducible and comparable assessment of the rheumatoid arthritis activity. DAS28-CRP in particular takes into account the following items:

TJC28: The number of tender joints (0-28).

SJC28: The number of swollen joints (0-28).

CRP: The C-Reactive Protein level (in mg/l).

GH: The patient global health assessment (from 0=best to 100=worst).

The 28 tender or swollen joint scores target the same joints (shoulders, elbows, wrists, metacarpophalangeal joints, proximal interphalangeal joints and the knees). The computation of the score is done through the following equation:

The interpretation of the score does not depend on its evolution over time. Generally, remission is considered achieved if the score is between 0 and <2.6. Low activity corresponds to 2.6 to <3.2. Moderate activity is between 3.2 and ≤5.1, while high activity is strictly above 5.1. However, the action that a specific value might trigger in terms of treatment choice may vary from one country to the other. In Belgium, a biological DMARD treatment will be initiated if the patient reaches a score of 2.7 or more. This value is 3.7 in France and more than 5 in the UK. In any cases, the DAS28-CRP is a strong predictor of disability and radiological progression [2].

Aside from DAS28-CRP, other scores exist, like the original DAS, taking into account 44 joints, or DAS28 (where CRP is replaced by ESR), CDAI (where CRP is replaced by the healthcare provider global assessment of the disease activity) or the SDAI (where the healthcare provider global assessment of the disease activity is added to DAS28-CRP).